Novel multifactor predictive model for postoperative survival in gallbladder cancer: a multi-center study

• Published in: World journal of surgical oncology Vol. 22; no. 1; pp. 263 - 15
• Main Authors: Deng, Kaige, Xing, Jiali, Xu, Gang, Ma, Ruixue, Jin, Bao, Leng, Zijian, Wan, Xueshuai, Xu, Jingyong, Shi, Xiaolei, Qiao, Jiangchun, Yang, Jiayin, Song, Jinghai, Zheng, Yongchang, Sang, Xinting, Du, Shunda
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.10.2024; BioMed Central; BMC
• Subjects: Aged; Care and treatment; Cholecystectomy - methods; Cholecystectomy - mortality; Demographic aspects; Diagnosis; Event history analysis; Female; Follow-Up Studies; Gallbladder cancer; Gallbladder cancer (GBC); Gallbladder Neoplasms - blood; Gallbladder Neoplasms - mortality; Gallbladder Neoplasms - pathology; Gallbladder Neoplasms - surgery; Humans; Inflammation; Male; Methods; Middle Aged; Neoplasm Staging; Nomogram; Nomograms; Postoperative care; Predictive model; Prognosis; Retrospective Studies; ROC Curve; Surgery; Survival; Survival Rate; Tumor markers; China; Tumor markers; Comorbidities; Nomogram; Surgery; Predictive model; Survival; Gallbladder cancer (GBC)
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-024-03533-z

Gallbladder cancer (GBC) is a highly aggressive malignancy, with limited survival profiles after curative surgeries. This study aimed to develop a practical model for predicting the postoperative overall survival (OS) in GBC patients. Patients from three hospitals were included. Two centers (N = 102 and 100) were adopted for model development and internal validation, and the third center (N = 85) was used for external testing. Univariate and stepwise multivariate Cox regression were used for feature selection. A nomogram for 1-, 3-, and 5-year postoperative survival rates was constructed accordingly. Performance assessment included Harrell's concordance index (C-index), receiver operating characteristic (ROC) curves and calibration curves. Kaplan-Meier curves were utilized to evaluate the risk stratification results of the nomogram. Decision curves were used to reflect the net benefit. Eight factors, TNM stage, age-adjusted Charlson Comorbidity Index (aCCI), body mass index (BMI), R0 resection, blood platelet count, and serum levels of albumin, CA125, CA199 were incorporated in the nomogram. The time-dependent C-index consistently exceeded 0.70 from 6 months to 5 years, and time-dependent ROC revealed an area under the curve (AUC) of over 75% for 1-, 3-, and 5-year survival. The calibration curves, Kaplan-Meier curves and decision curves also indicated good prognostic performance and clinical benefit, surpassing traditional indicators TNM staging and CA199 levels. The reliability of results was further proved in the independent external testing set. The novel nomogram exhibited good prognostic efficacy and robust generalizability in GBC patients, which might be a promising tool for aiding clinical decision-making.